Calcium salts

calcium carbonate

Apo-cal (CAN), Calciday, Calcite 500 (CAN), Calsan (CAN), Caltrate, Chooz, Equilet, Os-Cal, Oyst-Cal, Oystercal, Tums

calcium chloride

calcium gluceptate

calcium gluconate

calcium lactate

Pregnancy Category C

Drug classes


Therapeutic actions


Essential element of the body; helps maintain the functional integrity of the nervous and muscular systems; helps maintain cardiac function, blood coagulation; is an enzyme cofactor and affects the secretory activity of endocrine and exocrine glands; neutralizes or reduces gastric acidity (oral use).

Indications

Contraindications/cautions


Dosage


Available Forms: Tablets--500, 650, 975 mg, 1 g, 1.25 g, 1.5 g; powder--1250 mg; injection--10%, 1.1 g/5 mL

Adult

Calcium carbonate or lactate
RDA:
800 mg
Dietary supplement:
500 mg---2 g PO, bid---qid.
Antacid:
0.5---2 g PO calcium carbonate as needed.
Calcium chloride:
For IV use only: 1 g contains 272 mg (13.6 mEq) calcium.
Hypocalcemic disorders:
500 mg---1 g at intervals of 1---3 d.
Magnesium intoxication:
500 mg promptly. Observe patient for signs of recovery before giving another dose.
Hyperkalemic ECG disturbances of cardiac function:
Adjust dose according to ECG response.
Cardiac resuscitation:
500 mg---1 g IV or 200---800 mg into the ventricular cavity.
Calcium gluconate:
IV infusion preferred: 1 g contains 90 mg (4.5 mEq) calcium. 0.5---2 g as required; daily dose 1---15 g.
Calcium gluceptate:
IM or IV use: 1.1 g contains 90 mg (4.5 mEq) calcium; solution for injection contains 1.1 g/5 mL. 2---5 mL IM; 5---20 mL IV.

Pediatric

Calcium gluconate:
500 mg/kg per day IV given in divided doses.
Calcium gluceptate:
Exchange transfusions in newborns: 0.5 mL after every 100 mL of blood exchanged.

Pharmacokinetics

RouteOnsetPeak
Oral3---5 min
IVImmediate3---5 min

Metabolism: Hepatic; T1/2: 1---3 h

Distribution: Crosses placenta; passes into breast milk

Excretion: Feces, urine

IV facts


Adverse effects


Clinically important interactions


Nursing Considerations


Assessment


History: Allergy to calcium; renal calculi; hypercalcemia; ventricular fibrillation during cardiac resuscitation; digitalis toxicity
Physical: Injection site; P, auscultation, BP, peripheral perfusion, ECG; abdominal exam, bowel sounds, mucous membranes; serum electrolytes, urinalysis

Implementation



Drug-specific teaching points

Adverse effects in Italic are most common; those in Bold are life-threatening.